O054 - THE IMPACT OF EXOGENOUS KETONES ON POST-EXERTIONAL RECOVERY: A SYSTEMATIC REVIEW AND META-ANALYSIS

O054

THE IMPACT OF EXOGENOUS KETONES ON POST-EXERTIONAL RECOVERY: A SYSTEMATIC REVIEW AND META-ANALYSIS

S. M. Bomans^1,*, B. Jimenez Garcia¹, L. Leemans¹, O. Mohib¹, I. El M'Rabet¹, E. De Waele¹, P. Janssens¹, D. Beckwée²

¹Clinical Nutrition, UZ Brussel, ²Rehabilitation Research, Vrije Universiteit Brussel, Brussels, Belgium

Rationale: Traditional strategies for post-exertional recovery are insufficient in clinical populations. Exogenous ketone supplementation has been suggested to improve recovery, but its efficacy is still unclear.

Methods: A systematic review, meta-analysis and Grades of Recommendation, Assessment, Development and Evaluation (GRADE) approach were conducted. Three databases were searched on October 2024 for randomized controlled trials and cross-over studies examining the effects of exogenous ketones on post-exertional recovery markers in adults. RevMan 5.4.1 was used for the data analyses.

Results: There was a significant effect on muscle glycogen preservation with exogenous ketones (Standardized Mean Difference (SMD) = -1.05, 95% confidence interval (CI) [-1.83 to -0.26]) but not on lactate responses with either a low ketone dose (SMD = -0.27, 95% CI [-0.77 to 0.24]) or a high ketone dose (SMD = 0.11, 95% CI [-0.36 to 0.57]). There was no evidence of a beneficial effect of exogenous ketones on physical recovery (Mean Difference (MD) -0,41 (95% confidence interval (CI) [-2.67 to 1.86]), cognitive recovery (SMD -0.01, 95% CI [-0.40 to 0.37]) or muscle-related recovery (SMD = - 0.04, 95% CI [-0.46 to 0.38]). Figure 1 shows the GRADE findings.

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Conclusion: Current evidence does not support a consistent benefit of exogenous ketone supplementation for post-exertional recovery. Given the high heterogeneity in ketone doses used in the current studies, further research should aim to investigate optimal ketone dosing, timing and applicability across diverse (patient) groups.

References: Bleeker et al. (2020), Evans et al. (2018, 2019, 2022), Holdsworth et al. (2017), Jameson et al. (2022), Martin-Arrowsmith et al. (2020), Miyatsu et al. (2024), Norwitz et al. (2020), O’Malley (2017), Poffé et al. (2019, 2023, 2023), Prins et al. (2020, 2021), Quinones et al. (2024), Vandoorne et al. (2017), Waldman et al. (2018)

Disclosure of Interest: None declared